Division of Continuing Education

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Summer Residency Programs: Payment and Registration
Applicants who are accepted should use this form to submit payment. A $1,000 nonrefundable security deposit is
due on Ma¡r l, 2011, ensuring your space in the program. The remainder of your tuition is due two weeks prior to
the start of your program.
'rlÜra*tO X, ,r"NA
Last Name First Name

Social Security Number

Please select program and session(s) and housing (if applicable):

2l't Century Sound Design fl June 6 - July B tr $4000

Illustration üMay3l-JulyI f,l$2400

IMPACT:Design trJulyll-Augustlg D$ó000

Painting / Mixed Media .[ May 31 - July t tr $2400

.Vl"ry5-August5 Ul$z+oo D$4500

Photography IJunel-July2 tr$2400

üJuly6-August6 n$2400 tr$4500
D Equipment deposit tl $1100 (refundable)
Printmaking / Book Arts ü May 3l - July I tr $Z¿OO

Reconfiguring Site tr July l1 - Augusr 19 tr $6000

Sculpture / New Media E May 3l - July I D $2400

IJuly5-August5 tr$2400 n$4500
Still and Moving Imaging tr July 6 - August 3 tr $4000

Housing*
Residency Session I May 29 - July 3 n $1000.00
Residency Session II July 3 - August 7 n $1000.00
SoundDesign June5-July9 tr$I000.00
Still t Moving Imaging: New Technologies July 3 - August 7 n $1000.00
IMPACT July t0 - August 20 tr $IBTS.00
Reconfiguring Site July l0 - August 20 n $IBTS.00

* You must also fill out the Housing Application and Contract to be considered {or housing.

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TOTAL AMOUNT DUE $ !,
 Please indicate which of the following payments you are making at this time

\p6f,000 nonrefundable security deposit (included in the tuition)

,/\
ü Full tuition of my program $
llnter amount

E Remainder of the tuition of my program $

Enter amount

D Housing
Enter amount

Payment Method o check encloeed o noney order encrosed o -edir card (inrormaljo" or.*l X vV/Re fR4.1/<-eZ

Numbcr explrcs

Cardholder signature

(Please make all checks payable to School of Visual Arts)

Please send all matcrials to:
Keren Moscovitch, Program Coordinator Tel 212-592-2lBB
Diüsion of Continuing liducation Fax: 21 2-592-2060
School o{ Visual Arts kmoscoütch@sva.cdu
209 East 23 St
New York, NY 10010-3994

REFI-ND POLICY

A $1,000 nonre{'undable deposit is required upon acceptance to the program. Full tuition is due two weeks prior to the
start of the program. There will be no refunds once the program begins.

To withdraw from the program you must noti{y the Program Coordinator, I)ivision of Continuing Education, in writing, of
your_intention to withdraw. You may do so: by e-mailing your withdrawal to kmoscovitch@sva.edu; or by sending wriiten
notification via mail or fax. The Division of Continuing education is located at 209 East 23rd Street. All refunds for
payment made by American lixpress, Discover, MasterCard or Visa, will be credited to the appropriate credit card account.
Payment made try check or money order will be refunded by check, payable to the registrant. Processing of refunds takes
approximately four weeks.